Quadro-pulse stimulation is more effective than paired-pulse stimulation for plasticity induction of the human motor cortex

Hamada, Masayuki; Hanajima, Ritsuko; Terao, Yasuo; Arai, Noritoshi; Furubayashi, Toshiaki; Inomata‐Terada, Satomi; Yugeta, Akihiro; Matsumoto, Hideyuki; Shirota, Yasuhiko; Ugawa, Yoshikazu

doi:10.1016/j.clinph.2007.09.062

Cited by 103 publications

(102 citation statements)

References 41 publications

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“…They are inspired by patterned burst stimulation protocols applied in cortical slices to induce LTP or LTD [12,44]. Two patterned rTMS protocols have been established, called theta-burst stimulation (TBS) [12,15,53] and quadripulse stimulation [12,15]. The most commonly used TBS protocol applies 50 Hz bursts consisting of three TMS pulses at a burst repetition rate of 5 Hz.…”

Section: Approaches To Study Plasticity In the Intact Human Cortexmentioning

confidence: 99%

Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation

et al. 2015

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Homeostatic plasticity is thought to stabilize neural activity around a set point within a physiologically reasonable dynamic range. Over the last ten years, a wide range of non-invasive transcranial brain stimulation (NTBS) techniques have been used to probe homeostatic control of cortical plasticity in the intact human brain. Here, we review different NTBS approaches to study homeostatic plasticity on a systems level and relate the findings to both, physiological evidence from in vitro studies and to a theoretical framework of homeostatic function. We highlight differences between homeostatic and other non-homeostatic forms of plasticity and we examine the contribution of sleep in restoring synaptic homeostasis. Finally, we discuss the growing number of studies showing that abnormal homeostatic plasticity may be associated to a range of neuropsychiatric diseases.

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Section: Approaches To Study Plasticity In the Intact Human Cortexmentioning

confidence: 99%

Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation

et al. 2015

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“…An example of the strong potentiation of this form is seen with quadripulse protocols (Hamada et al 2007;Hamada et al 2008;Tsutsumi et al 2014). In the QPS5 protocol, a burst of four pulses 5 ms apart was applied once a second (Tsutsumi et al 2014).…”

Section: The Off Time In Itbs Is Critical For Achieving Potentiationmentioning

confidence: 96%

Calcium dependent plasticity applied to repetitive transcranial magnetic stimulation with a neural field model

et al. 2016

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The calcium dependent plasticity (CaDP) approach to the modeling of synaptic weight change is applied using a neural field approach to realistic repetitive transcranial magnetic stimulation (rTMS) protocols. A spatially-symmetric nonlinear neural field model consisting of populations of excitatory and inhibitory neurons is used. The plasticity between excitatory cell populations is then evaluated using a CaDP approach that incorporates metaplasticity. The direction and size of the plasticity (potentiation or depression) depends on both the amplitude of stimulation and duration of the protocol. The breaks in the inhibitory theta-burst stimulation protocol are crucial to ensuring that the stimulation bursts are potentiating in nature. Tuning the parameters of a spike-timing dependent plasticity (STDP) window with a Monte Carlo approach to maximize agreement between STDP predictions and the CaDP results reproduces a realistically-shaped window with two regions of depression in agreement with the existing literature. Developing understanding of how TMS interacts with cells at a network level may be important for future investigation.

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“…19 In the present case study on 3 subjects with a history of spinal cord injury, we combined low-frequency trains (0.2 Hz), short interpulse intervals (2-4 ms) and subthreshold stimulus intensities in an attempt to increase motor cortical excitability, as has been shown in ablebodied subjects. 12 Stimulation to leg area motor cortices was bilateral for subject number 3, yet the protocol we used when unilaterally stimulating the hand area has been shown to affect motor cortex excitability bilaterally by increasing inter-hemispheric interactions via the corpus callosum. 20 In the absence of any other intervention, even a single session of rTMS QP over the hand/forearm cortical motor area in our 2 subjects (numbers 1 and 2) targeted for hand function sometimes caused a modest improvement in dexterity of the treated hand, and was accompanied by modest increases in cortical and decreases in spinal excitability as assessed by MEP facilitation and T-response reduction, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The QuadroPulse stimulator delivers patterned rTMS shown to induce a broad range of cortical plasticity, varying from MEP facilitation to suppression depending on the parameters of stimulation. 12,13 In contrast to other rTMS techniques, the modulating effect of rTMS QP on motor cortex does not depend on polymorphism of the brain-derived neurotrophic factor (BDNF) gene, thus minimizing inter-individual variability, a critical aspect in any clinical study. 17 Although as many as 4 closelyspaced pulses can be delivered within each train, the QuadroPulse stimulator restricts the delivery of successive stimulus trains to rates not higher than 0.2 Hz (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…A single-session application of QuadroPulse rTMS (rTMS QP ) in able-bodied subjects was recently shown to safely increase cortical excitability more effectively than paired-pulse stimulation. 12,13 We wanted to see if a comparable effect of rTMS QP on motor cortex excitability in persons with SCI might lead to improvement in motor function. We report herein our findings of a wide-ranging exploration of different regimens of rTMS QP delivery-both alone and in combination with targeted exercise-in a small population of persons with SCI.…”

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Efficacy of QuadroPulse rTMS for improving motor function after spinal cord injury: Three case studies

Alexeeva

Calancie

2014

The Journal of Spinal Cord Medicine

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Context/objective: To examine the effects of repetitive QuadroPulse transcranial magnetic stimulation (rTMS QP ) on hand/leg function after spinal cord injury (SCI). Design: Interventional proof-of-concept study. Setting: University laboratory. Participants: Three adult subjects with cervical SCI. Interventions: Repeated trains of magnetic stimuli were applied to the motor cortical hand/leg area. Several exploratory single-day rTMS QP protocols were examined. Ultimately we settled on a protocol using three 5-day trials of (1) rTMS QP only; (2) exercise only (targeting hand or leg function); and (3) rTMS QP combined with exercise. Outcome measures: Hand motor function was assessed by Purdue Pegboard and Complete Minnesota Dexterity tests. Walking function was based on treadmill walking and the Timed Up and Go test. Electromyographic recordings were used for neurophysiological testing of cortical (by single-and doublepulse TMS) and spinal (via tendon taps and electrical nerve stimulation) excitability. Results: Single-day rTMS QP application had no clear effect in the 2 subjects whose hand function was targeted, but improved walking speed in the person targeted for walking, accompanied by increased cortical excitability and reduced spinal excitability. All 3 subjects showed functional improvement following the 5-day rTMS QP intervention, an effect being even more pronounced after the five-day combined rTMS QP + exercise sessions. There were no rTMS QP -associated adverse effects. Conclusion: Our findings suggest a functional benefit of motor cortical rTMS QP after SCI. The effect of rTMS QP appears to be augmented when stimulation is accompanied by targeted exercises, warranting expansion of this pilot study to a larger subject population.

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Quadro-pulse stimulation is more effective than paired-pulse stimulation for plasticity induction of the human motor cortex

Cited by 103 publications

References 41 publications

Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation

Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation

Calcium dependent plasticity applied to repetitive transcranial magnetic stimulation with a neural field model

Efficacy of QuadroPulse rTMS for improving motor function after spinal cord injury: Three case studies

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